Effect of Moola Bandha; Yoga intervention and internal administration of Changeri Ghrita (an Ayurveda formulation) through anorectal manometry-A randomized controlled clinical trial

Background: The Gudabhransha (rectal prolapse) is a disease in which displacement of the Guda (anorectum) from its normal position either part of the rectal wall or the whole rectal wall prolapsed through the anal opening. In males, the maximum incidence was in the second and third decades, in females, it was in the fifth and subsequent decades. Overall, prolapse of the rectum affects relatively few people (2.5 cases/100,000 people). The exact cause of rectal prolapse is not well addressed but it is often associated with long-standing, constipation, advanced age, severe cough, diarrhea, bleeding per rectum, and some neurological disorders. Aim: The aim of the study was to study the effect of Moola Bandha in male and female patients suffering from rectal prolapse ( Gudabhransha ). Materials and methods: Total of 20 patients were assigned to two groups (10 in each group) by computer-generated randomization. Patients aged 20–70 with symptomatic rectal prolapse in the interventional group were offered Moola Bandha along with Changeri Ghrita treatment modalities, while the control group was only on Changeri Ghrita treatment. All participants gave written informed consent. An assessment was done by improvement in chief complaints, digital rectal examination (DRE), grading system of rectal prolapse, and high-resolution anorectal manometry (HRAM) before treatment/therapy and at the end of 1, 2, 3, and 4 months. Results: Twenty patients underwent HRAM using 16 channels. Measurements were performed during rest, squeeze, and rectal sensations. Data were displayed as color plots and analyzed through the software of Anorectal manometry. The length of the anal canal, maximum basal pressure, and maximum squeeze pressure were measured before and after the treatment/therapy. At the end of the 4-month, poststudy comparison between and within the two groups showed a significant improvement in chief complaints. After intervention, 80% patients relief in prolapsed mass during defecation ( P < 0.008), sphincter tone of 60% patients become normal tone ( P < 0.01), 80% patients relief in discomfort through finger insertion in DRE ( P < 0.004) and 80% cases were changed the grade of rectal prolapse into normal anorectum ( P < 0.004). The pressure of the external and internal anal sphincter was comparatively increased after the intervention of Moola Bandha . Conclusion: It can be concluded that the rectal prolapse comparatively significantly regresses with combined management of Moola Bandha along with Changeri Ghrita treatment (intervention) rather than only Changeri Ghrita treatment. It could be stated that Moola Bandha is an effective add on method of treatment of rectal prolapse ( Gudabhransha) .